Login Name can be in upper or lower case and should be between 4 to 18 characters and contain no spaces. This is the name you will use to login to Applied.com.

Please choose a password:

Password can be in upper or lower case and should be between 4 to 18 characters and contain no spaces. Please make sure you remember your password!

Please enter password again to confirm:

Please enter a question which you will respond to if you forget your password.

Please enter your answer to the question above.

Customer Information

Required fields are marked with bold.

I am a government buyer.

Do you have an Account already with a local Applied Service Center?

Would you like an AIT representative to contact you to set up an account?

Is an Applied Sales Associate assisting you with the completion of this form?

Your First Name:

Your Last Name:

Title:

Email Address:

Please enter email again to confirm:

Company Name:

Purchasing
System

if Other:

Applied Account Number

How to find your Account Number
if you are an existing Applied Customer, please enter your account number so we will be able to process your request promptly.

Applied Account Manager

Applied Service Center

User
Notes

What is your primary job function?

if Other:

BillTo Address

Required fields are marked with bold.

Address1:

Address2:

City:

State/Province:

Country:

Zip:

Phone:

Ext.:

Fax:

ShipTo Address

Shipping Information is same as Customer Information

Required fields are marked with bold.

Address1:

Address2:

City:

State/Province:

Country:

Zip:

Phone:

Ext.:

Fax:

Would you like to receive periodic updates via emails?
Yes
No

The Applied.com logon that you requested will be activated
and will allow you to enter the Applied.com Web site and
choose from over 500,000 products for purchase with a credit card.

If you already have an established, business account number with
a local Service Center, you will be notified when your account
has been verified. At that time, you will have access to additional
features and payment options.